The acceptability of different HIV testing approaches: cross-sectional study among GMSM in Australia: Table 1

Yang, Minxian; Prestage, Garrett; Maycock, Bruce; Brown, Graham; Wit, John de; McKechnie, Michelle L.; Guy, Rebecca; Keen, Phillip; Fairley, Christopher K; Zablotska, Iryna

doi:10.1136/sextrans-2013-051495

Cited by 18 publications

(11 citation statements)

References 9 publications

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“…For the vast majority of men with non-reactive results, POCT removes the need for return visits and most men report that they find POCT less stressful and anxiety-provoking than conventional testing [ 30 , 31 ]. The majority of GBM report that they prefer convenient and accessible HIV testing with rapid or electronic provision of results, such as POCT, express clinics and community-based or self-testing [ 23 , 32 , 33 ]. Barriers such as the cost of testing and difficulty getting an appointment reported by Australian community-based GBM may represent difficulties accessing testing in general practice and other private clinics, but these were not commonly reported by our sample of GBM in sexual health clinics [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

“…Collaboration between government, service providers, and community-based organisations on enhanced public health responses is required to connect with younger, non-gay-identified men living outside traditional gay suburbs and to establish a regular pattern of frequent HIV testing for all sexually active GBM that does not rely on symptoms or self-perceived risk [ 12 , 32 , 49 , 50 ]. Regular frequent testing reduces the interval between HIV tests, facilitates serostatus awareness and timely HIV diagnosis among GBM and may in turn reduce infectiousness and HIV transmission through treatment as prevention [ 23 , 49 ].…”

Section: Discussionmentioning

confidence: 99%

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Barriers to HIV testing and characteristics associated with never testing among gay and bisexual men attending sexual health clinics in Sydney

Conway

Holt

Couldwell

et al. 2015

Journal of the International AIDS Society

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IntroductionHIV diagnoses among gay and bisexual men have increased over the past decade in Australia. HIV point-of-care testing (POCT) was introduced in Australia in 2011 as a strategy to increase HIV testing by making the testing process more convenient. We surveyed gay and bisexual men undergoing POCT to assess barriers to HIV testing and characteristics associated with not having previously tested for HIV (never testing).MethodsDuring 2011 and 2012, gay and bisexual men who were undergoing POCT at four Sydney sexual health clinics self-completed questionnaires assessing testing history and psychological and structural barriers to HIV testing. Bivariate and multivariate logistic regression was used to assess associations between patient characteristics and never testing.ResultsOf 1093 participants, 981 (89.9%) reported ever testing for HIV and 110 (10.1%) never testing. At least one barrier to testing was reported by 1046 men (95.7%), with only 47 men (4.3%) not reporting any barrier to testing. The most commonly reported barriers to testing were annoyance at having to return for results (30.2%), not having done anything risky (29.6%), stress in waiting for results (28.4%), being afraid of testing positive (27.5%) and having tested recently (23.2%). Never testing was independently associated with being non-gay-identified (adjusted odds ratio [AOR]: 1.9; 95% confidence interval [CI]: 1.1–3.2), being aged less than 25 years (AOR: 2.4; 95% CI: 1.6–3.8), living in a suburb with few gay couples (AOR: 1.9; 95% CI: 1.2–3.0), being afraid of testing HIV-positive (AOR: 1.6; 95% CI: 1.0–2.4), not knowing where to test (AOR: 3.8; 95% CI: 1.3–11.2) and reporting one or no sexual partners in the last six months (AOR: 2.7; 95% CI: 1.2–6.2).ConclusionsBarriers to HIV testing were commonly reported among the clinic-based gay and bisexual men in this study. Our findings suggest further health promotion and prevention strategies are needed to address the knowledge, attitudes and behavioural factors associated with never testing.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Barriers to HIV testing and characteristics associated with never testing among gay and bisexual men attending sexual health clinics in Sydney

Conway

Holt

Couldwell

et al. 2015

Journal of the International AIDS Society

View full text Add to dashboard Cite

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“…A second Excel data extraction "checklist", formulated from the 2015 TGA's clinical performance requirements for HIVST kits and Medical Device Essential Principles Checklist (Therapeutic Goods Administration, 2015a, 2015c) and outcomes of a literature review of international and Australian studies exploring what consumers and service providers consider the "ideal" information to accompany a HIVST kit (Bavinton et al, 2013;Krause, Subklew-Sehume, Kenyon, & Colebunders, 2013;Ng et al, 2012;Yang et al, 2014), was used to assess the content of the received kits and accuracy of the accompanying information. Table 1 shows the characteristics of the nine websites offering HIVST for purchase and delivery to Australia identified in each search round.…”

Section: Methodsmentioning

confidence: 99%

Implications of the on-line market for regulation and uptake of HIV self-testing in Australia

et al. 2016

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Self-Testing for HIV (HIVST) is widely recognised as a feasible and effective means of increasing rates of testing and detection of HIV, particularly in non-testing and infrequent testing populations. Currently in Australia, the only means of accessing this technology is to purchase unregulated products on-line. A search of available on-line distributers was purposefully performed from the perspective of an English-speaking individual, with no clinical background or specific understanding of HIV testing practices, seeking to determine their HIV status. Purchased kits were assessed against a structured extraction tool based on the Australian Therapeutic Goods Administration (TGA) HIV testing clinical performance guidelines. In total, eight HIVST kits were purchased from seven different distributers. Analysis of the purchased kits and linked websites revealed that none met the TGA's requirements for HIV testing kits intended for home use; none also conformed to the additional recommendations for information, quality and links to services developed from this study's review of HIVST associated literature. People seeking HIVST kits are able to purchase sub-standard products that ill-serve their needs, and do so at a time of great personal vulnerability. The fact that Australians are willing to purchase and use these sub-standard products indicates HIVST is in demand. Health policy and models of service are needed in order to ensure people have access to a safe and effective registered device at prices that enable equity of access to all Australians, particularly those most at risk of HIV. Other countries awaiting access to regulated HIVST devices also need to consider the potential implications. Collaboration between manufacturers, distributers, regulatory bodies, service providers and the community is needed globally in order to ensure HIVST is embedded into testing methods in a manner that does not disrupt but rather safely and effectively increases HIV testing rates.

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“…Antibody based rapid and point of care (POC) tests for HIV have allowed expanded access to HIV testing and have been a breakthrough for HIV testing in resource-limited settings, and high income settings alike. [ 14 – 18 ] Patients can receive rapid results, saving time and repeat visits. [ 19 ] However, the second and third generations of rapid HIV POC tests are antibody based, inherently limited to detecting HIV infection post-seroconversion (after 3–4 weeks).…”

Section: Introductionmentioning

confidence: 99%

Evaluation of a Rapid Point of Care Test for Detecting Acute and Established HIV Infection, and Examining the Role of Study Quality on Diagnostic Accuracy: A Bayesian Meta-Analysis

et al. 2016

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IntroductionFourth generation (Ag/Ab combination) point of care HIV tests like the FDA-approved Determine HIV1/2 Ag/Ab Combo test offer the promise of timely detection of acute HIV infection, relevant in the context of HIV control. However, a synthesis of their performance has not yet been done. In this meta-analysis we not only assessed device performance but also evaluated the role of study quality on diagnostic accuracy.MethodsTwo independent reviewers searched seven databases, including conferences and bibliographies, and independently extracted data from 17 studies. Study quality was assessed with QUADAS-2. Data on sensitivity and specificity (overall, antigen, and antibody) were pooled using a Bayesian hierarchical random effects meta-analysis model. Subgroups were analyzed by blood samples (serum/plasma vs. whole blood) and study designs (case-control vs. cross-sectional).ResultsThe overall specificity of the Determine Combo test was 99.1%, 95% credible interval (CrI) [97.3–99.8]. The overall pooled sensitivity for the device was at 88.5%, 95% [80.1–93.4]. When the components of the test were analyzed separately, the pooled specificities were 99.7%, 95% CrI [96.8–100] and 99.6%, 95% CrI [99.0–99.8], for the antigen and antibody components, respectively. Pooled sensitivity of the antibody component was 97.3%, 95% CrI [60.7–99.9], and pooled sensitivity for the antigen component was found to be 12.3%, 95% (CrI) [1.1–44.2]. No significant differences were found between subgroups by blood sample or study design. However, it was noted that many studies restricted their study sample to p24 antigen or RNA positive specimens, which may have led to underestimation of overall test performance. Detection bias, selection (spectrum) bias, incorporation bias, and verification bias impaired study quality.ConclusionsAlthough the specificity of all test components was high, antigenic sensitivity will merit from an improvement. Besides the accuracy of the device itself, study quality, also impacts the performance of the test. These factors must be kept in mind in future evaluations of an improved device, relevant for global scale up and implementation.

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The acceptability of different HIV testing approaches: cross-sectional study among GMSM in Australia: Table 1

Abstract: Australian GMSM prefer alternative testing approaches, possibly due to their convenience. The availability of new testing approaches may provide more options for GMSM at risk for HIV infection, improve access to HIV testing and potentially increase HIV testing rates.

Cited by 18 publications

References 9 publications

Barriers to HIV testing and characteristics associated with never testing among gay and bisexual men attending sexual health clinics in Sydney

Barriers to HIV testing and characteristics associated with never testing among gay and bisexual men attending sexual health clinics in Sydney

Implications of the on-line market for regulation and uptake of HIV self-testing in Australia

Evaluation of a Rapid Point of Care Test for Detecting Acute and Established HIV Infection, and Examining the Role of Study Quality on Diagnostic Accuracy: A Bayesian Meta-Analysis

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